Your spine is made up of stacked vertebral bones with a disc between each. The spinal discs provide support, allow for movement between bones, and help prevent the bones from rubbing against one another. They are also shock absorbers.
A bulging disc is where the disc protrudes outward from where it is supposed to sit. A bulging disc can be asymptomatic if it is not pressing on the nerve.
Literature will refer to “bulging,” “herniated,” “ruptured,” and “protruding” discs interchangeably. However, Dr. Melamed distinguishes between these terms: a bulging disc involves a protrusion without a break in the annulus (the outer fibrous ring), while a herniated disc involves a protrusion with a break that allows contents to leak out. In practical terms, both descriptions refer to the same concern: whether the disc is close enough to irritate or compress spinal nerves and other structures.
Recognizing Bulging Disc Symptoms
Symptoms will vary according to the location of the bulging disc and whether a nerve is being irritated or pinched. Many people are asymptomatic if the disc is not causing nerve compression.
Common symptoms include:
- Pain near the area of the bulge, which can be mild to severe
- Radiating pain in an arm or leg
- Numbness or tingling if a nerve is being pressed on
- Weakness if an affected nerve controls certain muscles
- Loss of range of motion or ability to move easily
- Possible back spasms
- Sciatica-like symptoms if the bulge is in the lower back, since the sciatic nerve can be affected by lower back issues
- Symptoms may include stiffness in the neck and symptoms radiating into the shoulder/arm/hand if a nerve root is compressed in the neck region
One set of symptoms should be treated with special urgency: loss of bowel or bladder control suggests a rare but serious emergency involving nerve compression, often referred to as cauda equina syndrome. Immediate medical attention is needed under those circumstances.
Common Causes and Risk Factors
Bulging discs are often associated with age-related changes in the disc itself. Dr. Melamed says that discs tend to lose flexibility as people age and that spinal discs often lose water content and become more brittle over time. He states that the condition is described as developing gradually over time, with one possible precursor being a tear or fissure in the annulus that develops slowly and then contributes to the bulge.
Injury can also cause a bulging disc. An accident (such as a car accident or fall) can contribute to the development of issues with spinal discs, and injury may also worsen symptoms.
Risk factors include:
- Degenerative changes associated with age, which may occur more frequently after age 40
- Altered posture so that pressure is placed on certain areas over time
- Repetitive motions related to jobs or activities that lead to repeated lifting or bending
- Being overweight or obese
- Smoking
- High-impact sports
- Genetics
How Beverly Hills Spine Specialists Diagnose Bulging Discs
A diagnosis can help make sure there is a match between reported symptoms and what’s occurring in the spine, while also confirming through proper imaging that this is indeed causing problems.
Imaging is also routine and vital. X-ray may be used to assess overall spine state; MRI is often used for detecting bulging discs; and CT/myelograms may also be requested if extra information needs to be gathered.
Bulging Disc Treatment Options
Dr. Melamed’s approach is conservative treatment followed by precise surgical options when necessary. Being conservative is the best approach because multiple reviews suggest that up to about 90% of herniated or bulging disc cases improve over about 6 months with non‑surgical care, such as physical therapy, activity modification, targeted exercise, and medications, which explains why conservative care is usually the first‑line recommendation in Beverly Hills clinics.
Treatment is typically guided by the severity of any symptoms, the location of the bulge, and whether there is nerve compression caused by the bulging disc. Dr. Melamed uses a holistic approach to bulging discs, which may include elements from integrative medicine, chiropractic medicine, and acupuncture.
Dr. Melamed may recommend simple exercises and behavior changes (including smoking cessation), as well as non-opiate medications to address some of the pain and discomfort.
Another reference mentions non-surgical options for treating cervical bulging discs, such as:
- Physical or chiropractic therapy with stretching and strengthening exercises
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or other over-the-counter medications for pain relief and inflammation
- Massage therapy to help relax muscles
- Injectable anti-inflammatory medications
- Rest
Some procedures may be considered if conservative treatments are not successful over time. Dr. Melamed mentions three uses:
- A microlaminotomy is a minimally invasive surgery that opens up the spinal canal with a very small incision, providing more space for displaced tissue causing the bulge.
- A microdiscectomy is the removal of some or all of the structure that’s causing issues.
- A spinal fusion may be chosen to improve stability and reduce pain by joining the vertebrae.
Surgery becomes relevant when symptoms are severe or serious enough to require addressing the underlying cause.
What To Expect: Recovery and Outcomes
Ideally, if there’s an option for non-invasive treatment, that’s what is recommended. Many cases improve without intervention; one reference states that most cases of herniated discs will heal and resolve with non-invasive treatment.
If an untreated bulging disc becomes a herniated disc and surgery is required, minimally invasive techniques are emphasized.
Make an Appointment With Dr. Melamed
If you think a bulging disc could be behind your back pain, Dr. Hooman Melamed’s approach emphasizes careful diagnosis and conservative treatment. To take the next step, schedule an appointment with Dr. Melamed today.
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and Billing
We provide a very high level of individualized and concierge care. Therefore, we are out-of-network with almost all insurances, but as long as you have out-of-network benefits, we are happy to work with you, bill on your behalf, and verify your benefits.
